Transcript Communities Putting Prevention to Work New York City

Obesity Prevention in
New York City:
Improving Health through System, Infrastructure,
and Environmental Change Strategies
Gretchen Van Wye, PhD, MA
Deputy Director, Chronic Disease Prevention
New York City Department of Health and Mental Hygiene
Lancaster Summit
May 24, 2012
Overview of NYC
New York City
•
•
•
•
8.4 Million residents
5 boroughs (counties)
Many neighborhoods
Ethnically diverse




35%
27%
24%
36%
White
Hispanic
Black
Foreign-born
Bronx
Manhattan
Queens
Brooklyn
Staten Island
• 21% live in poverty
• 1.8 million on Supplemental
Nutrition Assistance Program (SNAP)
Obesity Has Been Increasing in Adults
Self reported obesity, NYC, 1994-2010
25%
21.7%
% of NYC Adults Obese
20%
20.1%
21.1%
22.1%
22.6%
23.3% 23.4%
19.9%
18.2%
15.5%
15%
14.0%
15.0%
12.3%
10%
5%
0%
1994-95 1996-97 1998-99 2000-01
2002
2003
2004
2005
2006
2007
2008
2009
2010
57% of adults overall and 70%
of adults in high-need areas are
overweight or obese
9.3% report diabetes
30.3% drank one or
more sugar-sweetened
beverages per day.
Citywide Prevalence: 11.6%
The Obesity Problem: No Balance
Calories consumed exceeds calories burned
Food is now:
Ubiquitous
Cheap
High in Calories
Served in Large Portions
Heavily Promoted
Physical activity:
Has been designed out of our
environment
Food is Ubiquitous:
Food Store Density in New York City
Food outlet type
Outlets per square
kilometer
Food stores
Supermarkets and medium-sized groceries
3.5
Fruit and vegetable markets
1.6
Bodegas/convenience stores
16.6
Other food stores
10.4
Restaurants
Fast food
3.4
Pizza
4.2
Other restaurants
38.9
Total
78.6
Source: Rundle A et al. Neighborhood food environment and walkability predict obesity in New York City.
Environ Health Perspect 2009;117:442-447.
Cost: Junk foods are Cheaper Compared
to Fruits and Vegetables (F&V)
Who would expect this many calories
(more than half a day’s worth for most adults)
in one meal?
16 ounces of Coke used to be enough for 3
people!
Source: The World of Coca Cola, Atlanta Georgia 2011.
Exploding Beverage Sizes:
McDonald’s Drinks Have Grown 457% Since 1955
45
42
One Size
42
Child
40
Super-size discontinued
except for special
promotions
Small
35
Medium
32
32
32
32
32
Large
30
Size (ounces)
Super Size
25
21
21
21
20
16
16
Only size
available!!
15
12
12
10
7
5
0
1955
1961
1962
1974
1988
1999
2003
2004
2010
1. Young L. The Portion Teller Plan: The No-Diet Reality Guide to Eating, Cheating, and Losing Weight Permanently. New York: Morgan Road Books, 2005. Print ; McDonald’s
Website, retrieved November 10, 2010: http://nutrition.mcdonalds.com/getnutrition/nutritionfacts.pdf
…Heavily Marketed...
Promotions encourage
customers to purchase large
portions to get “value”
McDonald’s and Wendy’s have
dropped the Supersize, Biggie
and Great Biggie descriptors and
now call the same huge sizes
Medium or Large
Healthy Eating
• Promote environmental changes that increase access to
healthy foods and decrease consumption of unhealthy foods
• Encourage adoption of healthier food procurement standards
in public and private settings
• Continue to lead and expand the National Salt Reduction
Initiative and manage the national salt monitoring system
• Support the achievement of baby-friendly hospital status
among NYC hospitals
16
Reducing Consumption of
Sugar-Sweetened Beverages
Goal: Reduce by 5% the percentage of adults
who consume 1 or more daily sugar sweetened
beverages
Impact: Approximately 93,000 of 1,856,000
adult NYers who reported consuming an average
of 1 or more SSBs per day in 2010
How:
• Educating New Yorkers on the harms of
sugary drink consumption
• Develop additional standards for healthy foods
and beverages in new settings, for example
meetings and events located at City agencies
Reducing Sodium Consumption
Goal: Monitor trends in sodium and key
nutrients in US processed foods as part of
the National Salt Reduction Initiative
(NSRI) goal to reduce sodium in packaged
and restaurant foods by 25% by 2014
Impact: Impact all of the US populationapproximately 311 million people
How:
• 28 companies have committed to date
• Monitoring changes in sodium through
databases and company reports -analyses underway
Decrease
sodium content
in foods by
25% over 5
years
Decrease
population
sodium intake
by 20% over 5
years
Reduce risk of
heart disease–
the leading
cause of death
in US
Baby-Friendly
Goal: Increase from 2 to 12 the number of
NYC public and private hospitals that are
certified as Baby Friendly and increase the
number of hospital working to become
more baby friendly.
Impact: Approximately 78,750 births in
NYC over the next 5 years; 46,000
mothers of low SES. 25 of 40 maternity
hospitals in NYC.
How: By establishing and running a
Hospital Learning Collaborative and
providing technical assistance.
Early Successes
Obesity Prevalence in K-8 Decreased
from 21.9% to 21%
2006-07
2007-8
2008-9
2009-10
25.0
7 to 10 year olds
24.0
11 to 14 year olds
Obesity prevalence
5 and 6 year olds
23.0
22.9
Overall
22.0
21.9
21.7
22.2
21.0
20.0
21.1
21.0
20.2
19.0
18.0
NYC Fitnessgram data, 2006-2010
18.3
Decrease in Sugary Drinks
Decrease in Percent of Adults
Eating No Fruits & Vegetables
Thank you!
Gretchen Van Wye, PhD, MA
Deputy Director – Chronic Disease Prevention
New York City Department of Health & Mental
Hygiene
[email protected]